Clinical implications of basic science discoveries: Immune homeostasis and the microbiome - Dietary and therapeutic modulation and implications for transplantation

Abstract

Links between the human microbiome and the innate and adaptive immune systems and their impact on autoimmune and inflammatory diseases are only beginning to be recognized. Characterization of the complex human microbial community is facilitated by culture-independent nucleic acid sequencing tools and bioinformatics systems. Specific organisms and microbial antigens are linked with initiation of innate immune responses that, depending on the context, may be associated with tolerogenic or effector immune responses. Further complexity is introduced by preclinical data that demonstrate the impacts of dietary manipulation on the prevention of genetically determined, systemic autoimmune disorders and on gastrointestinal microbiota. Investigation of interactions of complex microbial populations with the human immune system may provide new targets for clinical management in allotransplantation. Since the human microbiome is linked to the control of local and systemic tolerogenic and effector immune responses via the innate immune system, dietary manipulation is an important modulator of gastrointestinal flora and, in preclinical models, alters the presentation of genetically determined autoimmune disorders.